Currently, no insurer has filed plans in two counties – Klickitat and Grays Harbor.

Two insurers, Community Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, announced earlier this year that they will not participate in the 2018 individual health insurance market.

As of March 2017, 1,119 people in Klickitat County and 2,227 in Grays Harbor County were enrolled in the individual market.

OK, that's 3,346 current enrollees who are at risk of not having any options in 2018. Klickitat County has around 21,000 residents; Grays Harbor has around 71,000, so that's roughly 92,000 people between the two. Assuming roughly 85% are covered by group coverage, Medicare, Medicaid or some other type of policy, that leaves roughly 14,000 residents in those counties who could potentially be impacted by the bare county problem.

Under current state law, if no health insurer is available in a particular county, the only coverage option is through Washington state’s high-risk pool, WSHIP. However, because WSHIP is not a qualified Exchange insurer, subsidies would not be available.

“I will be reaching out to our health insurers this week to strongly encourage them to reconsider their participation in the two counties that have no options for 2018,” said Insurance Commissioner Mike Kreidler. “After that, I will look for whatever options are available at the state level to protect the stability of our health insurance market. The more than 316,000 consumers who buy their own health insurance are counting on us to do no less.”

“I’m deeply troubled by the changes we’re seeing for next year’s health insurance market,” said Kreidler. “The proposed drop in insurers and coverage areas clearly indicates to me that the uncertainty the Trump administration and the GOP-controlled Congress has sowed for months is sabotaging the progress we’ve made. Their actions, including failing to commit to fund the cost-sharing subsidies, not enforcing the individual mandate, and continuing to push in secret the severely flawed American Health Care Act are eroding confidence health insurers have in the market here and across the nation. These actions only increase premiums and decrease insurer participation.

“The Affordable Care Act has worked in Washington state because we fully embraced the reforms it offered – including expanding Medicaid and creating our own state Exchange. These decisions helped increase competition, provided better coverage and access, and fueled the largest drop in our uninsured in decades. Much more could be done to improve upon our progress, but that would take congressional action focused on shoring up the law, versus taking it down.

“For months, we’ve worked closely with our health insurers and other stakeholders in a concerted effort to try to explain to the Trump administration and congressional leaders what the impact could be to our market and most importantly, to our consumers, if this level of uncertainty and volatility continued. Today, our predictions came true."